Prevention of Osteoporosis Starts Young

Jason Eberhart-Phillips, MD
Kansas State Health Officer

Chances are the teenagers you know aren’t thinking much about the far-off future when they will be middle-aged adults. Their attention is probably focused more on the latest hip-hop music than on the prevention of the hip fractures 30 or 40 years from now.

It’s up to parents and other grown-ups to think ahead for them, making sure that young people have the best opportunities for good health all through their adult lives.

That’s why so many parents, teachers and health professionals are more concerned than ever about what kids are eating today, and how common deficiencies in their diets might be predisposing them to serious health problems in adulthood.

Obviously the enormous intake of high-calorie foods that is typical for many teenagers today puts young people at risk of obesity, a set-up for high blood pressure, diabetes, heart disease and cancer as they grow into adults. Obesity in children and teenagers is now widely recognized as one of our nation’s most pressing public health problems.

But another serious dietary risk confronting our teens gets far less attention: It’s how our kids’ diets – particularly the beverages they are drinking – are putting the future health of their bones at risk.

Osteoporosis, a potentially crippling disease characterized by low bone density and increased bone fragility, usually doesn’t show up until middle age. But the seeds of this pernicious disease are sown during adolescence, when the skeleton is most active in absorbing dietary calcium and building up nearly all the bone mass that will carry the teenager throughout life.

For lifelong bone health, it is essential for teenagers – particularly girls – to consume enough calcium while they are young to achieve their maximum bone density. Time is of the essence. By the mid-20s the critical window period for calcium absorption starts to close, as a woman’s ability to stockpile this mineral in her bones is greatly reduced.

Today only about 14 percent of teenage girls in America are thought to have enough calcium in their diets to avoid osteoporosis by the time they reach menopause in their 50s. Only one girl in seven now consumes enough dairy products and other foods rich in calcium to attain an adequate bone mass that will prevent brittle bones and disabling fractures when they enter the middle and later years of life.

The insufficient consumption of calcium by teens today points directly to a public health crisis by the middle of this century that will shatter millions of lives and cost society billions of dollars for health care. But it’s all preventable if we act now.

Calcium intake among teens used to be much higher than it is today. As recently as the late 1970s, teens aged 12 to 19 years reported drinking nearly twice as much milk as they drank soda. Now the picture is almost reversed, with milk consumption among teens down 40 percent, while soda consumption has doubled.

Soft drinks are problematic not only because they have displaced calcium-rich milk as a source of refreshment. The caffeine that most sodas contain also increases the excretion of calcium in the urine, further reducing the calcium available for bone development.

We can’t let the coming osteoporosis crisis happen. It’s time now for parents and policy makers alike to find ways to limit excessive soda consumption among teens and encourage increased intake of low-fat milk and other healthy sources of calcium.

Parents can do a lot in the home environment to nudge their teenagers to eat better by restricting sodas and making sure that healthier alternatives are readily available. Another way to increase young people’s exposure to healthy foods is to set higher nutritional standards for the foods sold in school vending machines and stores.

The Kansas legislature is currently considering a new statute that would do just that. Senate Bill 499 would require every school district in the state to follow the same “exemplary” guidelines for the sale of so-called “competitive foods” in schools that a minority of Kansas districts now follow voluntarily. These guidelines restrict beverages sold in schools to water, low-fat milk and 100% juice.

Parents, educators and health professionals from around the state are rallying around the bill as a first step in assuring not only healthy bone development, but also better oral health, reduced obesity and improved academic performance. They want schools to better practice what they already preach about good nutrition in the Kansas health curriculum.

Most teenagers can’t imagine being middle-aged, let alone having brittle bones. But unless we who understand the risks act now to improve their diets, that’s the future they can expect.

Dr. Eberhart-Phillips is the Kansas State Health Officer and Director of Health in the Kansas Department of Health and Environment. He can be reached at jeberhart-phillips@kdheks.gov.